Complications of Rubella virus
المؤلف:
Baijayantimala Mishra
المصدر:
Textbook of Medical Virology
الجزء والصفحة:
2nd Edition , p195-196
2025-11-05
63
Arthralgia is the most common complication which occurs in 30 to 60% of teenagers and adult females. Joint involvement appears almost one week after rash and commonly persists for a week. It can affect any joint but fingers and knees are commonly involved.
Encephalitis and thrombocytopenia are the other complications of rubella.
Congenital Rubella Syndrome
Maternal immunity is protective against intrauterine infection. Rubella virus can cause severe congenital defects when acquired during in utero through transplacental transmission from infected mother. The infection when occurs in the pregnant women during the early part of gestational period up to 8–10 weeks the transplacental transmission occurs in up to 90% of cases, which decreases to 25% during second trimester, rises again to 35% at 27–30 weeks and near 100% at 36 weeks of gestation. However, the severity and risk of fetal malformation decreases with the acquisition of infection in mother during advanced gestational period. The risk is almost nil when infection in mother occurs after 16 weeks of gestation.
In susceptible pregnant women, the infection spreads to placenta then crosses the placenta and spreads to various organs of fetus through the vascular system. The possible mechanisms of fetal damage are epithelial necrosis of chorionic villi, apoptosis and inhibition of mitosis by direct viral effect on infected cells, restricted precursor cell development and damage to endothelial cell of blood vessels resulting in ischemia in developing organs.
The classical triad of congenital rubella syndrome consists of cataract, cardiac defects and sensory neural hearing loss which typically occurs when the neonate gets infected during first 8 weeks of gestation. Sensorineural hearing loss occurs in maximum (80%) cases and cataract and cardiac defects in 50–60% of cases.
Sensory neural hearing loss is usually bilateral. In some cases, it may be the sole manifestations whereas in some cases it may not be apparent till second year of life.
Patent ductus arteriosus and pulmonary artery and valvular stenosis are the common cardiac defects.
Amongst the ophthalmic abnormalities, cataract, pigmentary retinopathy and con genital glaucoma are the common ones. Pigmentary retinopathy is characterized by salt and pepper appearance of fundus.
The common manifestations of congenital rubella syndrome (CRS) are given in Table1.
Table1. Manifestations of congenital rubella syndrome
Diagnosis of CRS is often based on the detection of rubella specific IgM antibody in the cord blood or in the serum of infant within first six months of life.
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